Kashmiris take to drugs

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Inam Rashid (name changed) was among the many unfortunate men to be picked up and interrogated by state agencies trying to ferret out possible links of locals with militancy. For five days he was put under extreme interrogation and subsequently released without being charged. As if the mental scars of this ordeal were not enough, the 35-yearold lost 12 members of his family to the massive Uri earthquake of 2005. Rashid subsequently sought a grim refuge in multiple addictive substances - cannabis, nicotine, opium, ethanol and benzodiazepine - "to erase the memories of his extended sufferings".

Rashid is one among thousands of Kashmiris who, despairing of the continuous disruptive violence around them, are increasingly seeking refuge in drugs. Several studies carried out on addiction in the Valley reveal a strong correlation between conflict and drug abuse - they show that drugs here are not used for recreational purposes but as a coping mechanism to deal with the stresses of an over-20-year conflict in the most militarised region in the world. And with scarcely any mental healthcare facilities or de-addiction centres in the Valley, Kashmiris have been left to fend for themselves.

While reliable statistics on addiction are notoriously difficult to come by in Kashmir, several government and independent studies have been trying to track the scale of the problem. In a study done at the Government Psychiatric Diseases Hospital (GPDH) in 2002, doctors compared drug trends among patients from 1980- '88 and 2002 before the armed conflict erupted and after. The results were shocking, with an increase of over 60 per cent being reported in the use of opioid-based preparations (9. 5 per cent to 73. 61 per cent), and an over 25 per cent increase in multiple substance abuse (15. 8 per cent to 41. 6 per cent), from the 1980s to 2002. In another GPDH study conducted in 2006, it was discovered that of the 561 substance-use disorder patients, 63. 85 per cent of patients had either experienced or witnessed multiple traumatic events, qualifying for the diagnosis of Post-Traumatic Stress Disorder (PTSD) compared to 36. 14 per cent patients who had exposure to one traumatic event.

The easy availability of prescription drugs over the counter has contributed to the enormity of the malady (almost 50 per cent of medical shops in the Valley are unlicensed, says Dr Wiqar Bashir of the Batamaloo Drug De-addiction Centre). Currently, 80 per cent of drug users in the Valley are those who consume drugs containing opioids such as Corex and codeine. Sources in the peddling business reveal that the Valley consumes 6, 000 bottles of codeine per day - of this, Sopore alone consumes over 3, 000. "If you visit the Degree College in Sopore, you will find that 80 per cent of the boys are on codeine, " say ex-addicts who shared this information with doctors. An addict recalls the desperation of his friend, who, during a strike in the city, was forced to pay Rs 5, 000 for three bottles of codeine. "He was in such a bad state. He needed it badly. So he shelled out the money and bought the bottles on the black market. "

It's not just opoids - benzodiazepines like Diazepam and Alprazolam and cannabis derivatives like hashish, marijuana and alcohol are freely used as well. Besides, items of common use like polish and glue double up as inhalants for school students, even girl students. Indeed, the use of nicotine, Iodex, diluters, sleeping pills and inhalants like boot polish, Fevicol and ink removers has been observed in female addicts who might not have the means to obtain other not-so-easily available substances.

In Kashmir the drug problem has metastasized for several reasons. "To begin with, the role of the drug-monitoring agencies in controlling the menace is zero, " emphasises a doctor. In fact, the law chooses to look the other way - persons booked under the Narcotics Drugs and Psychotropic Substances (NDPS) Act, which is nonbailable in all other states, can be released on bail in Kashmir. The police too are not authorised to take action under this act against chemists for misuse of prescription drugs. A high-ranking official, who estimates that Sopore and South Kashmir are the worst hit areas, admits that it is difficult to break the nexus between chemists, peddlers and the police. "There is a problem of denial in Kashmir, " he says. "As long as that persists, it is impossible to resolve this problem. A lack of awareness compounds it - in rural Kashmir, families are unaware if a drug is being abused in their midst. The womenfolk don't know that the man of the house is an addict. They think he's taking medicines. In that case, how can they help him?"

A 2005 study titled 'Deviance among adolescents', which aimed to research drug abuse among youth in areas of armed conflict, reveals that college students in Srinagar and Kupwara, both male and female, were observed using drugs and alcohol. A total of 20 per cent boys and 14 per cent girls were involved in drug abuse, and 34 per cent cases were at risk for potential suicide. Interestingly, boys and girls from middle-class families constituted 70 per cent of drug abusers. Professor A G Madhosh, the lead researcher for the study, says that four other studies titled 'Women and children under armed conflict' have been commissioned by the Government of India. Sources related to the study say that the highest concentration of addicts is in highly militarised regions such as Kupwara - the problem, he adds, is exacerbated on account of the army giving addicts free access to drugs and alcohol.

The army-drug link is confirmed by other sources as well. A doctor from Srinagar realised this after he came across a patient who used to source his prescription drugs from an army camp. Others say that not only have the armed forces encouraged addiction openly, there have been also instances where they have come down heavily on locals who tried to fight it. A journalist remembers an incident in North Kashmir where after several fruitless attempts to get the police to act upon a group of addicts who would routinely gather at a bus terminal, some youth and elders of the village joined hands to deal with the nuisance. Violence ensued after the group of addicts refused to budge from the spot. The following day, the same villagers were assaulted by personnel from a local army camp, recalls the source. "The villagers were assaulted brutally, and were categorically warned by the army to leave the addicts alone, " says the journalist.

A police official agrees to the fact that the army was involved and elaborates on how it all started and why. He recalls how in the '90, drugs were used by the security forces as a strategy to seek information on militants. "In the 1990s, when militancy was at its peak, the security forces used to exchange drugs for information provided by ex-militants, " he says. "The situation is different now - militancy is almost eliminated, but the drug issue has become worse over the years. " As sociologist Dr B A Dabla says, "We lost one generation to the gun and we are going to lose the next to drugs. "

Efforts towards remedial action, though woefully short, do exist. In 2004, the Government Medical College's department of psychiatry conducted awareness and intervention programmes in Srinagar, Anantnag and Baramulla. A record 2, 500 patients were identified and a treatment plan was formulated. Many underwent detoxification and a lesser number continued with the treatment. The department of psychiatry treats at least 2, 000 patients with drug-related problems a year, 90 per cent of them between 17 to 35 years of age. Mêdecins Sans Frontières (MSF), an international humanitarian aid organisation, also works to address this burgeoning situation in the Valley through weekly counselling sessions. "Awareness is a big part of trying to form a solution, " says a team member. "Psycho-educating addicts and their families about the problem, the nature of the drug disorder, the necessary treatment and the manner in which to deal with the addict is a very important part of this work. " In Kashmir's case, he adds, emphasis should be laid on judicious and appropriate prescription of psychotropic drugs.

The Srinagar's Police Control Room's sevenbed de-addiction facility in sees two to three fresh cases a day, says doctors - this despite the social stigma attached to being treated by the police. "If this centre was located outside these premises, we'd get thousands of cases, " says a doctor. "The lack of infrastructure forces us to turn away the large number of patients who come from faraway villages. It's heartbreaking but we can't help it. " Three patients died recently after they were turned away due to unavailability of beds - two of drug overdose and one committed suicide.

According to social worker Yasir Zahgeer, who has been working with drug addicts for the last eight years, increasing the number of doctors is not the answer to this problem which is spiralling out of control. "Even if the existing de-addiction facilities are expanded, there will be a shortage of counsellors, who are a crucial input in preventing relapse, " he explains. "Initially, when the addict is admitted to our Centre, doctors play 70 per cent of the role until the withdrawal symptoms disappear, and the counsellors play 30 per cent of role in the first week. After that, the ratio is reversed. We need counsellors in the long term to teach them how to resist going back to drugs and to develop new techniques in coping with everyday stress factors. "

Unless there are immediate measures taken in all quarters of society, and a long-term effort is made to re-integrate this population into the mainstream, the youth of Kashmir will pass on this disease to their next generation, warns Dr Maajid. "It is scientifically proven that chronic stress alters the genotype of the individual, " he says. "Children will imbibe the behaviour of the parents if they are suffering from PTSD. Stress will lead to drug abuse. The next generation will be genetically pre-disposed to using drugs, and this will exacerbate the problem. "

Instead of alienating addicts, or "hanging them from Lal Chowk", as a community leader put it, the need of the hour is for society to support an addict through de-toxification and counselling thereafter. There's also a need to crack down on suppliers and expose the entrenched nexus that protects drug peddlers. Unless these measures are taken post-haste, Kashmir will continue plummetting into an abyss.